Institutional Aid Form | Immaculata University

Student ID*

(i.e. A00123456)

Name*

First Last

Phone*

Email

Select a Financial Aid Year*

2017-2018 Financial Aid Year (Fall 2017, Spring 2018, & Summer 2018)
2018-2019 Financial Aid Year (Fall 2018, Spring 2019, & Summer 2019)

Fall Semester Credits*

Please enter a value between 0 and 21.

Spring Semester Credits*

Please enter a value between 0 and 21.

Summer Semester Credits*

Please enter a value between 0 and 21.

(If you are taking courses in Summer 1 and Summer 2, please add them together.)

1. Are you receiving any tuition remission from Immaculata University?*

Yes
No

If yes, what is the reason for the remission?

Employee Benefit
Employee Dependent Benefit
IMH Congregation Member
Relative of IHM Congregation Member employed by IU
Relative of IHM Congregation Member not employed by IU
International Sister
Other Religious Order Discount
Full-time Teacher/Administrator in a Catholic School

2. Are you receiving any tuition benefit from your employer?*

Yes
No

If yes, how much?

3. Are you receiving any scholarships and/or grants from private donors during the academic year?*

Yes
No

If yes, from whom and how much?

Desired Financing Level

I wish to be awarded my maximum eligibility for Federal Direct Student Loans.
I wish to be awarded a specific amount of my Federal Direct Student Loans.

The specific amount of Federal Direct Student Loans is $

By accepting these terms and conditions, I certify that all the information on this form is true and complete to the best of my knowledge. I understand that any changes to the information must be submitted in writing to the Office of Financial Aid.*

I accept

To electronically sign this document, please enter your date of birth.*

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